What is Tooth Wear?

Tooth wear is part of life and happens naturally as we get older.

In the same way that tyres wear out from many kilometres on the road, teeth will wear from the brushing, eating and drinking every day of your life. Here though, we are not talking about the normal ageing effects on your teeth, we are talking about other ways in which tooth substance can be lost, as distinct from dental caries and trauma.

Tooth wear may be referred to as ‘tooth surface loss’ by your dentist, and whilst we can treat it, it is an irreversible process and so, like many other things in dentistry- prevention is the key.

Tooth wear can happen in three ways (with a contentious fourth), although often a combination of more than one is at the heart of the problem:

On its own erosion presents a problem, but the effects are amplified dramatically when combined with attrition or abrasion.

Why is Tooth Wear an Issue?

Tooth wear can be very simple to treat if caught early and very complex later on- once considerable changes have taken place.

The main problems associated with tooth wear are:

Aesthetics

(i) Short teeth. Attrition can shorten the heights of your teeth and over time cause facial changes because of the lost height (OVD).

(ii) Yellow teeth. Erosion, attrition and abrasion can cause unsightly exposure of the more yellow dentine underneath the enamel, or of the root surface. The tops or sides of your back molar teeth tend not to be a visual problem but if the enamel on the front of your top teeth becomes thinned, it often gets a little transparent and the darker dentine underneath will become more visible through it.

I had a friend who went through a phase of drinking alco-pops like barcadi breezers regularly in his late teens and the enamel practically disappeared off his front teeth, much to his dismay. This was never going to grow back and so, for cosmetic and sensitivity issues, he opted to have porcelain veneers– something which could have been avoided if only he had known.

(iii) Worn and damaged teeth. If you grind your teeth, you are far more prone to chipping and fracturing your teeth and existing fillings. Often patients would complain that their front teeth looked ‘jagged’ or ‘chipped’. This is because the enamel had broken away, after the dentine supporting it underneath had been eroded. This can certainly be an aesthetic problem for some people.

Sensitivity

Enamel has no nerve endings, but any exposure of dentine or root surface, either through tooth brush abrasion, erosion, attrition, or a combination, can result in sensitivity to cold, hot and sweet things.

Sometimes even chewing can cause sensitivity- if the occlusal (top surfaces) of your teeth have been affected. This can range from something very mild to severe discomfort at the slightest temperature change.

Plaque and food traps

Erosion can cause pitting (little pot holes) in the biting surfaces of your molar teeth that can trap plaque and food. Severe toothbrush abrasion, if the teeth become significantly notched, can lead to plaque collecting around the gum margins.